| NPI | 1578637161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN MATTHEW FAHEY President Owner 248-625-6820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |